Where Next For the NITI Aayog?

The NITI Aayog must be converted from a Department of Development Implementation to a High Command of Development Strategy.

https://www.business-standard.com/article/opinion/reforming-the-niti-aayog-122051601487_1.html

That’s the very last sentence of a thought-provoking column by Nitin Desai. The column is about why the NITI Aayog (in Nitin Desai’s opinion) hasn’t done all of what was hoped of it, and what needs to change for some of these hopes to be realized.

But for us to reach the end of this column, we need to start somewhere, and we’ll start with the setting up of the Planning Commission.


The Indian planning project was one of the postcolonial world’s most ambitious experiments. It was an arranged marriage between Soviet-inspired economic planning and Western-style liberal democracy, at a time when the Cold War portrayed them as ideologically contradictory and institutionally incompatible. With each Five-Year Plan, the Planning Commission set the course for the nation’s economy. The ambit ranged from matters broad (free trade or protectionism?) to narrow (how much fish should fisheries produce to ensure protein in the national diet?). The Commission’s pronouncements set the gears of government in motion. Shaping entire sectors of the economy through incentives, disincentives and decree, the Planning Commission’s views rippled across the land to every farm and factory. Despite this awesome power, economic planning in India was considerably different from the kind practised in communist regimes. The Planning Commission was reined in by democratic procedure that required consultation with ministries in an elected government, with people’s representatives in Parliament—and ultimately with the popular will—through citizens voting every five years.

Menon, Nikhil. Planning Democracy (p. 9). Penguin Random House India Private Limited. Kindle Edition.

That’s from a book I’m currently reading (and thoroughly enjoying), Planning Democracy. There’s a lot to like about the book, and I hope to write a full review once I’m done, but for the moment, think about just the title. There’s a (hopefully healthy) tension implicit in it, because as the excerpt above puts it, the Planning Commission was to be reined in by democratic procedure.

What was it supposed to do? Further on in the same chapter from the book I have just quoted is a nice compact description of what was supposed to have happened:

Its potency stemmed from its authority to draw up an economic roadmap for the country and back it with all the resources and policy instruments available to the Government of India.

Menon, Nikhil. Planning Democracy (p. 21). Penguin Random House India Private Limited. Kindle Edition.

That is, there are two separate but interlinked things worth noting: it had to develop an plan of economic development for a newly independent India, and in order to do so, it had the backing in terms of resources and policy instruments. By the way, there is a reason the word “resources” has not been qualified with a word like financial – the back was not just financial, but also political, given the presence of the Prime Minister and other cabinet ministers as members.

The story of how the Planning Commission evolved, struggled, and refined itself over time (not always successfully, it should be mentioned) is a fascinating one, but not one that we can cover in a single blog post, alas. But long story (very) short, the Planning Commission came to an end in 2015:

Born the same year, Modi and the Planning Commission shared another milestone together. In his first Independence Day address as India’s leader, Modi declared that the Planning Commission had once merited its place and made significant contributions. Now, however, he believed it had decayed beyond repair. ‘Sometimes it costs a lot to repair an old house,’ he said, ‘but it gives us no satisfaction.’ Afterwards we realize ‘that we might as well build a new house’, Modi explained with a smile. He would build it by bulldozing a decrepit structure and raising a shiny new one, the NITI Aayog (National Institution for Transforming India).

Menon, Nikhil. Planning Democracy (p. 8). Penguin Random House India Private Limited. Kindle Edition.

And how has the NITI Aayog done?

But despite progress in these areas, some 7 years since the establishment of NITI Aayog, questions are being raised as to whether India can continue to function without medium-term planning. Annual budget allocations are made by the Finance Ministry to meet various investment goals and objectives but without a well-defined plan. NITI Aayog’s advice is also not taken seriously by state governments as it comes without resources. Some feel that NITI Aayog should have resources it allocates to address development imbalances and that the Ministry of Finance is naturally focused on budgetary management rather than development outcomes.6While no one wants a return to the old Planning Commission, a more involved and competent NITI Aayog, with a stronger voice is clearly needed.

Ajay Chhibber, 2022. “Economic Planning in India: Did We Throw the Baby Out with the Bathwater?,” Working Papers 2022-03, The George Washington University, Institute for International Economic Policy.

The idea itself isn’t all that new. Back in 2019, Vijay Kelkar had given a speech in which he proposed “NITI Aayog 2.0”:

It should rather strive to be a think tank with “praxis” possessing considerable financial muscle and devote its energies to outline coherent medium and long term strategy and corresponding investment resources for transforming India. Towards this, my preliminary study suggests that the NITI Aayog 2.0 will annually need the resources of around 1.5% to 2% of the GDP to provide suitable grants to the States for mitigating the development imbalance. These formulaic annual grants, whether capital grants or revenue grants for the relevant CSS will need to be conditional to ensure that (1) outcomes are commensurate and (2) it discourages an individual State to adopt policies that have negative policy externalities, e.g., creation of populist subsidies and thus avoid race to the bottom. Such presence of “negative policy externalities” we notice often, e.g., the provision of free “electricity,” irrigation water subsidies, etc. “Gresham’s Law” seems to be relevant not only for the currency markets alone!

Towards India’s New Fiscal Federalism, No. 252, NIPFP Working Paper Series, Vijay Kelkar (https://www.nipfp.org.in/media/medialibrary/2019/01/WP_252_2019.pdf)

If you don’t know what Gresham’s Law is, take a look here.


All of which eventually gets us back to the column that we started with, by Nitin Desai:

The real problem of strategy formation for development is that it is not being done. The NITI Aayog has produced some vision documents; but they are not agreed strategies formulated after widespread consultations with experts and discussion with the states. The word “niti” in the name of this organisation is an abbreviation for National Institution for Transforming India. This task requires looking a level above the designing of programmes to a strategy from which programmes must be derived.
A grand strategy for development must spell out the opportunities and threats faced by the key objectives of development which are growth, equity and sustainability. It must then identify the changes in the role of the public and private sector, shifts in global economic alliances and policy shifts that are required to maximise benefits from opportunities and manage risks from threats. The time frame for a grand strategy has to be long-term but the more specific strategies derived from it must take into account short- and medium-term challenges that the country faces.

https://www.business-standard.com/article/opinion/reforming-the-niti-aayog-122051601487_1.html

We need, that is to say, a NITI Aayog that focuses on not just reporting what has been (or is being) done, but also on explaining what needs to be done, over what time period, and why, along with some pointers towards what risks we might encounter. Or as Nitin Desai puts it, “The new Vice-Chairman, Suman Bery, must bring in the talent required and launch a process of broad-based consultation, particularly with the states, to secure a broad national consensus on a long-term growth strategy. Specific programmes must be based on the implementation of this strategy.”

Easier said than done, of course, but this is where NITI Aayog needs to go next.

The Solow Model and China

If you don’t know what the Solow model is, here is a great place to get started:

There are 11 videos in that series, and if you can spare the time, please watch all of them. Just two a day (they’re not more than 5 minutes each), and you’ll be done come the weekend.

But in effect, here is what the Solow model says:

  1. Output for a nation is a function of three (actually four) things:
    1. Capital (K): Buidings, ports, dams… infrastructure, basically.
    2. Education Augmented Labor (eL): The amount of hours that a person is able to put in to their work, but with the built in assumption that an educated person is likely to be more productive than a person without education.
    3. Ideas: Read the paragraph below to get a sense of what this means in practice.

Think about this blogpost that you are reading. I wrote it using my laptop, which is my capital. I will spend about an hour (that’s my plan, I’ll update you towards the end of this post about how well it worked out) writing it, and that’s the labor that I’ll be putting into this post. The fact that I have been “educated” in economics should mean that this post will be easier to write for me than, say, a gardener. The gardener could have written this post as well, of course, but it’s safe to assume that she would first have had to learn about the Solow model, and that, presumably, would have taken longer.

So that’s K and eL where the output (this blogpost) is concerned. But now think about it this way: what if another person, with a similar level of economics education as mine were to write this blogpost instead of me? Would that person have chosen this video, and these paragraphs to explain the Solow model? Maybe they would have recommended some other video, or some other podcast, or chosen to share details of an online textbook in which the Solow model is explained. That’s one way to think about ideas.

And so when you combine the capital (the laptop), the labor (the time I spend on this blogpost, given my education levels) and the ideas (what I choose to put into this blog post, and how), you get the output you’re reading right now.

What if I double the capital? Will the blogpost be done in half the time? Say I have an external monitor attached to my laptop – will two screens mean finishing the blogpost in half the time? It will save some time, but not by a factor of two, surely. Trust me, I have tried.

What if I double the labor? Hire an assistant to write this blogpost with me? The way I work, trust me, it will probably take longer! What if I go get a post-doc, to augment my education? Will that save me time? The hysterical laughter you hear in the background is the response of any PhD/post-doc student anywhere in the world, and that sound means a loud and resounding no.

In a sense, the Solow model asks these and related questions, and answers them using some graphs and equations. Except, of course, the Solow model does it for not one guy writing one blog, but for an entire nation at a time. There is no sense in me explaining the whole model over here, for it would be a case of me reinventing what is already a very good wheel. Please watch the videos.


But the Solow model is a remarkably useful way to get a handle on the long run growth prospects of a country. Is India likely to grow in the future? Well, is it going to add to its capital stock? Yes. Is it going to augment it’s stock of education augmented labor? Yes. Is it likely to produce more ideas than it is right now? Yes. And so the growth prospects for India look reasonably good.

Of course, there is more to the Solow model. All of this holds true given a strong and stable political system, well established rules of law, and strong and capable institutions. But so long as you believe that these are likely to continue to be so in the Indian case, you should be bullish on India.

What about, say, Japan? It has a capital stock that is more in need of replacement than new construction ( a feature of the Solow model that we have not discussed here, called depreciation), so it is unlikely that it will grow its capital stock too much. Here’s an example of what I mean. What about it’s stock of education augmented labor? Well, the news ain’t very good. Ideas? Trending upwards, but not by much. So if I had to bet on which country would grow more over the next twenty years, I would bet on India, not Japan.

Bear in mind that this is a model, and like all models, it is an imprecise abstraction of reality. So it is possible that at the end of the twenty year period, we find out that I am completely wrong. But if you think the Solow Model is a reasonably good model, you ought to bet the way I did.


So what about China?

Well, now, that’s a whole different story, and one that Noah Smith talks about in a recent blog post. Long story short, he doesn’t think China’s growth prospects are that great.

But the story is a little more complicated than that. The Solow model is a good model, sure, but it’s not as if the Chinese authorities/experts aren’t aware of the problem. And in his blog post, Noah looks at arguments put forth by two people who know a thing or two about China, and analyzes them critically.

The first argument is that sure, China’s demographics are on a downward trend, but what if we raised the retirement age for Chinese workers? Would that not solve the problem? Noah says no, probably not, because firms made of exclusively old folks isn’t necessarily a good idea. I wholeheartedly agree.

What about adding to China’s urbanization, and therefore its infrastructure? After all, China’s urbanization rate is “only” 64%. The inverted quotes around only in the previous sentence is because we, in India, are officially at 31%, but as in the case of China, it very much is a function of how you define urbanization. But similarly, in China, the urbanization rate is actually way more than 64%, and the Lewis turning point has already taken place in China, or will do so any moment.

And about ideas, well, China is an even more complicated story. Noah makes the point that China’s industrial policy is essentially a one-man army that is trying something that has never been tried before, and Noah is betting on it not quite working out. And given the events of the last year and a half or so, it is hard to disagree.

And so the Solow Model would probably tell you that China is unlikely to grow as fast in the near future as it did in the recent past, and even if you take into account potential adjustments, it likely will still be the case that China’s growth rate will start to plateau.


Please, read the entire post by Noah. But if you are a student of economics who has not yet met the Solow Model, begin there, and then get on to Noah’s post – your mileage will increase considerably.

CinemaRare on Hidden Gems on Zee5

I plan to spend part of this summer watching movies, and this list seems to be a good way to get started with movies from India:

Reflections on Whole Numbers and Half Truths

Single narratives have never been able to explain all of India.

S, Rukmini. Whole Numbers and Half Truths: What Data Can and Cannot Tell Us About Modern India (p. 220). Kindle Edition.

There is this line that is often quoted when big picture discussions about India take place, and it is only a matter of time before it comes up: whatever you say about India, the opposite is also true. The quote is attributed to Joan Robinson, and I can’t help but wonder if I will end up creating a paradox of sorts by agreeing wholeheartedly with it.

But I do agree with the spirit of the quote, which is why that one line extract from Rukmini S’s book, Whole Numbers and Half Truths, resonated so much with me. All countries are complex and complicated, but India takes the game to giddying heights.

Take a look at this map, a version of which is present in Rukmini’s book:

https://en.wikipedia.org/wiki/List_of_states_and_union_territories_of_India_by_fertility_rate

What is India’s TFR? First, for those uninitiated in the art and science of demography, what is TFR? It stands for Total Fertility Ratio, or as Hans Rosling used to put it, babies per woman. Well, it’s 2.0, which is good, because roughly speaking, two parents giving birth to two children will mean we’re at the replacement rate (note that this is a very basic way of thinking about it, but useful as a rough approximation).

But as any student of statistics ought to tell you, that’s only half the story (or half the truth). Uttar Pradesh, Bihar and Jharkhand are well above the so-called replacement rate, and that will have implications for labor mobility, taxation, political representation and so, so much more in the years to come.

Data then, is only half the story. How is the data collected? If it is a sampling exercise rather than a census, how was the sampling done? Has the sampling method changed over time? If so, are earlier data collection exercises comparable with current ones?

How should one think about the data that has been collected? What does it mean, and how much does context matter? For example:

‘That’s data about marriage, madam,’ he said—not about love. ‘I think if your data asked people if they have ever fallen in love with someone from another caste or religion, many will say yes. I see that all around me among my friends. But when it comes to getting married, most of us are not yet ready to leave our families. That’s why your data looks like that,’ he said. As for the rest? ‘There is a lot we will not admit to someone doing a survey. But things are changing. At least for some of us,’ he said.

S, Rukmini. Whole Numbers and Half Truths: What Data Can and Cannot Tell Us About Modern India (pp. 127-128). Kindle Edition.

Rukmini’s excellent book is, in one sense, a deep reflection on the data that we have, have had, and would like to have where India is concerned. It speaks about how data has been collected, which are the agencies and institutions involved, how these have changed (and been changed) over time, and with what consequences.

But it also is a reflection on a truism that many economists and statisticians underrate: data can only take you so far. As the subtitle of her book puts it, it is an analysis of what data can and cannot tell you about modern India.

And what data leaves out is often as fascinating as what it includes:

Yet, most people know little about the NCRB’s processes and methodology. For instance, the NCRB follows a system known as the ‘principal offence rule’. Instead of all the Indian Penal Code (IPC) sections involved in an alleged crime making it to the statistics, the NCRB only picks the ‘most heinous’ crime from each FIR for their statistics. I stumbled upon this then unknown fact in an off-the-record conversation with an NCRB statistician in the months after the deadly sexual assault of a physiotherapy student in Delhi in September 2012. In the course of that conversation, I learnt that the crime that shook the country would have only made it to the NCRB statistics as a murder, and not as a sexual assault, because murder carries the maximum penalty. This, I was told, was to prevent the crime statistics from being ‘artificially inflated’: ‘If the FIR is for theft, there will be a[n IPC] section for assault also, causing hurt also. If you include all the sections, people will think these are separate crimes and the numbers will seem too huge,’ he told me. After I reported this,2 the NCRB for the first time began to include the ‘principal offence rule’ in its disclaimer.3

S, Rukmini. Whole Numbers and Half Truths: What Data Can and Cannot Tell Us About Modern India (p. 13). Kindle Edition.

The paragraph that follows this one is equally instructive in this context, but the entire book is full of such Today-I-Learnt (TIL) moments. Even for those of us involved in academia, there is much to learn in terms of nuance and context by reading this book. If you are not in academia, but are interested in learning more about this country, recommending this book to you is even easier!

Rukmini’s books spans ten chapters on ten different (but obviously related) aspects of India. We get to learn how Indians tangle (or quite often choose not to!) with the cops and the courts, how we perceive the world around us, why Indians vote the way they do in the first three chapters. The next three are about how (and with whom) we live our lives, and how we earn and spend our money. The next trio is about how and where we work, how we grow and age and where Indians live. The final chapter is about India’s healthcare system.

Each chapter makes us familiar with the data associated with each of these topics, but each chapter is also a reflection on the fact that data can only take us so far. When you throw into the mix the fact that the data will always (and sometimes necessarily) be imperfect, we’re left with only one conclusion – analyze the data carefully, but always bear in mind that the reality will always be more complex. Data is, at the end of the day, an abstraction, and it will never be perfect.


One reason I liked the book so much is because of its brevity. Each of these chapters can and should be be a separate book, and condensing them into chapters can’t have been an easy task. But not only has she managed it, she has managed to do so in a way that is lucid, thought-provoking and informative. Two out of these three is a good achievement, to achieve all three and that across ten chapters is a rare ol’ achievement.

If I’m allowed to be greedy, I would have liked a chapter on the world of data that the RBI collects, and to its credit does share with us via its website. But it does so in a way that is best described as unintuitive. In fact, a book on how data sharing practices with the citizenry need to improve out of sight where government portals across all verticals and at all levels are concerned would be a great sequel (hint, hint!).


I’d strongly recommend this book to you, and I hope you enjoy reading it as much as I did.

We will be hosting Rukmini on the Gokhale Institute campus this coming Friday, the 29th of April. The event will be from 5.30 pm to 7.00 pm at the Kale Hall. She and I will speak about the book for about an hour, followed by a Q&A session with the audience.

If you are in Pune, please do try and make it!

Read Blogs Written by Gulzar Natarajan

Regular readers must be sick and tired of hearing me say this, I suppose, but please: read blog posts written by Gulzar Natarajan!

Especially so if you happen to be a student of economics. The art of taking a complex topic, asking simple questions about it, marrying them to the appropriate economic concepts that will help in the analysis, and reaching a cogent, well argued conclusion is a rare, rare skill. And Gulzar Natarajan possesses it in spades!

Consider the post titled The Demand Supply Gap in Medical Education.

The demand supply gap is stark. About 1.6 million students appeared for the National Eligibility cum Entrance Test (NEET) in 2021, of which only 88,120 make it to the 562 public and private medical colleges. That’s 19 applicants for every seat. Those numbers are now 89,875 and 596.
How do you analyse this market? What will be the impact on seat prices due to supply changes of medical seats? How will the supply side react to this situation of large numbers of Ukraine returned students? What will be the profile of supply side?

https://gulzar05.blogspot.com/2022/03/the-demand-supply-gap-in-medical.html

These are not hard questions to frame. In fact, I would argue that most of us will be able to frame these questions even without having studied economics formally. But that being said, framing them this simply and concisely takes years of practice.

He identifies four main problems that we need to deal with:

  1. The major constraint is the source of quality faculty
  2. Private supply of medical colleges is unlikely to make up the shortfall (he explains why in the post, and I tend to agree)
  3. As he puts it, “In an acutely supply deficient market, the limited marginal supply is likely to bid up the medical seat prices even more”. I would only add one word to this sentence, between the words marginal and supply: quality. It’s not so much about the supply going up as it is the degree to which high quality supply goes up.
  4. Ah, but alas, that brings us to an even more difficult question: quality as it truly exists, or quality as perceived by prospective students and by society? I studied in Fergusson College in Pune, so I have a moral right to ask this question. And that’s what he means by the phrase “lemon problem“. If you’re wondering why this is known as a lemon problem, take a look at this.

His preferred solution is having the government step in to augment the supply, using government district hospitals and some area hospitals. This, he says, is preferable to the public-private-partnership (PPP) model. I don’t dispute the assessment of the PPP model, and its shortcomings. But I’m curious about why he would say that government institutions are always going to assure a certain basic minimum assured quality. Is this necessarily true, even in a relative sense? And if so, why?

And the concluding paragraph is at once depressing and optimistic:

Finally, this is a teachable example on the reality that though many problems have no immediate solutions, we try to solve them. Part of it is about wanting to do something and also be seen doing something. This is a human reflex and a political economy compulsion. Bridging the demand-supply gap in medical education is one such problem. Given our context and constraints, it’s very unlikely that we can bridge this gap in the foreseeable future. Like with other similar problems like affordable housing, agricultural productivity, or traffic congestion, we can only create the conditions required for its mitigation and gradual easing.

https://gulzar05.blogspot.com/2022/03/the-demand-supply-gap-in-medical.html

Depressing because, as he says, it is unlikely to be solved any time soon. Optimistic because creating the conditions is easier said than done, but it is achievable.

What might these conditions be? How does one go about creating them? If you’re interested in the answers to these questions, you are, like it or not, now a student of economics and public policy.

P.S. And the answers themselves require many more blogposts, but please, feel free to search around on this blog for some of ’em! 🙂

Aamdani rupaiya, kharcha atthanni

If you’re not familiar with the Hindi language, the title of this post is a play on a fairly popular phrase: aamdani atthanni, kharcha rupaiya

In effect, your income is less than your expenses. Which, of course, isn’t a desirable state of affairs:

For all of the last decade, the primary metric for evaluating budgets was the fiscal deficit. How much would the government target to bring it down by, and how credible were the numbers? The source of that stress was the massive stimulus set in motion by the government well before the global recession showed up, as it was inundated by taxes in the 2006 to 2008 period. The challenge with that stimulus was that it was hard to roll back, much of it being a large increase in state and central government salaries and pensions.

https://tessellatum.in/?p=409

But we find ourselves in unchartered territory, says Neelkanth Mishra:

Tax collection is surprising positively, and should be more than 1 per cent of GDP higher than before the Covid-19 lockdowns (though assumptions are lower). Further, financial markets appear to be expecting both central and state governments to incur large fiscal deficits for several years, with the anchor shifting higher by 3 per cent of GDP. Let us assume that GDP being below where it was supposed to be if the pandemic had not happened means an extra per cent-and-a-half of costs for the government. Interest costs have risen as governments borrowed to bear a large part of the economic loss during the lockdowns. Further, some government expenses, like salaries and pensions, keep rising irrespective of the level of GDP. This still leaves 2.5 per cent of GDP of space for governments to increase spending.

https://tessellatum.in/?p=409

And as it turns out, it is unchartered territory for everybody, the government itself included. Neelkanth Mishra points out that we’re bringing off-budget items on to the budget, we’re paying off export incentives that were due, and the debt write-off for India has also been accounted for. Even so, he says, cash balances maintained by the government with the RBI are at an all time high.

So what can be done? Well, part of the answer this time around lies in asking the states to step up and spend on building out physical infrastructure:

The sharp increase in capital expenditure from Rs 5.45 trillion to Rs 7.5 trillion shows the intent of the government is to stay away from distributing freebies (commendable, given the upcoming state elections), and focus instead on productive spending, which may be rolled back if necessary. However, half of this increase is an allocation for interest-free loans to state governments for capital expenditure, and some of the rest is the inclusion of off-budget provisions in last year’s budget in the budget numbers this year. There are increases in the allocation for defence (particularly once adjusted for the lower spend on aircraft purchases this year), the Nal se Jal scheme, and for roads and railways, but these are incremental rather than substantial.
Allowing state governments more fiscal space (deficits up to 3.5 per cent of GDP are allowed, with another half a per cent if the state undertakes power sector reforms), and dangling the carrot of more funding if they undertake capital expenditure is the right approach in theory. Much of the necessary investments need to occur at the state level: Like in health, education, urban infrastructure, water supply, sanitation and power distribution. However, the gap between states’ intent to spend and their execution has widened substantially during the pandemic, and their total spending is far lower than budgeted, despite increases in non-discretionary expenses like interest costs, salaries and pensions.

https://tessellatum.in/?p=409

And the limiting factor there, ironically, is limited state capacity.

…many developing countries and organizations within them are mired in a “big stuck,” or what we will call a “capability trap”: they cannot perform the tasks asked of them, and doing the same thing day after day is not improving the situation; indeed, it is usually only making things worse. Even if everyone can agree in broad terms about the truck’s desired destination and the route needed to get there, an inability to actually implement the strategy for doing so means that there is often little to show for it—despite all the time, money, and effort expended, the truck never arrives.

Andrews, M., Pritchett, L., & Woolcock, M. (2017). Building state capability: Evidence, analysis, action (p. 10). Oxford University Press.

In other words, we have more money to spend this year, but our constraint is quite literally our inability to spend it usefully and efficiently.

It would be worth our collective while, then, to learn a little bit more about state capacity!

Visualization and the NFHS

A very quick post today, because the end of the year is proving to be anything but a holiday, alas.

My third post in the series about NFHS was going to be about a pet theme (and peeve) of mine: our inability to get better visualization for our data, and indeed better reporting of data in general. But there is good news on this front, finally – there is now an excellent resource that we can use to visualize the results of the NFHS-5 survey.

Here’s just one chart to whet your appetite: blood sugar level among adult women (high, or very high or taking medicine). Note that the chart for men is largely similar.

https://geographicinsights.iq.harvard.edu/nfhs-tracker-districts

This is great work, and kudos to everybody associated with this visualization project! 🙂

H/T: Shashank Patil

What is the story that NFHS-5 is telling us?

… is, if you ask me, a question that we should ask ourselves, rather than have this question be answered for us by somebody else.

What I mean by that is that I could tell you what I think of the results, or I could point you to articles written by others that tell you what they think of the results. But the results are out there for us to analyze, easily available and fairly readable in terms of accessibility.

Here is the India fact sheet, and here is where you can access data split by states.


I would recommend that you not take the easy way out, by reading what other folks have written. Sit instead, with these reports, and take a look at the big picture – the all India level data. Then begin with the Indian state that you call home, and check how it is doing. Compare India’s performance and your state’s performance with some states that you think ought to do well, and some that you think might be relative laggards on health parameters.

See if the data matches your intuition. And if it doesn’t, ask if you should suspect the data or your intuition (or both!). Begin to build, no matter how long it takes, a picture of India’s health status in your head.

Ask questions about India’s population, its split by gender, ask about our obesity rates and split those up by states. Ask about whether men are doing better than women on some parameters, and if so which – and eventually, why. Ask if there are major changes between the 4th and the 5th round, and ask if the rate of improvement between the 4th and the 5th is different from the rate of improvement between the 3rd and the 4th. Then ask if these numbers are comparable at all, given that there is a difference of ten years in the latter case, but only 5 in the former.


Try to come up with a list of ten points at the all-India level that seem noteworthy to you. And once you’re done with the list, then take a look at what the newspapers and columnists and op-eds are saying.

Is the story that you have come up with similar to theirs? If not, why? Might it be because they’ve done a better job in highlighting relevant material, or might it because they’re biased in some ways? Do you think they’re biased because of what they’ve written in the past, or because their interpretation of NFHS-5 differs from yours, or both? What is the probability that you are biased against them, rather than they being biased while writing whatever it is that they have written? How can one tell, really?

The bottom-line is this: if you consider yourself a student of economics, don’t form your opinions and biases by mirroring and mimicking the opinions and biases of folks you like. Begin with the data, form your own opinions, and then test them against those of others. Defend your ideas and conclusions by pitting them against those of others, and by engaging in respectful debate.

It’s a good way to study our country! 🙂

Update: Please take a look at this excellent Twitter thread about the history of NFHS. H/T: Sumita Kale.

Understanding the idea behind the NFHS

Why should you, as an informed citizen of this country, be aware of how well India is doing in terms of health?

The question isn’t rhetorical. For its own sake is a more than good enough answer, of course, but here are additional reasons for keeping track of how well we’re doing as a country in terms of health:

  • If you think that the Solow model is a good way to start to think about the long term growth prospects of our nation, then thinking about the health of that workforce is important
  • If you think it is possible that different states may have different health outcomes, it makes sense to try and understand whether this is the case.
  • It also makes sense to dig into the data and try and understand the particulars of these differences. (A state may do poorly on life expectancy in comparison to other states, for example, but better along other dimensions. Why might this be so is an excellent question to ask, and this is just one of many possible questions.)
  • This is true for many other ways to “slice” this data. Are there different outcomes by, say, gender? By urban/rural divide?
  • The answers to each of these questions is important because it helps us understand how to build a framework to answer the mot important question of them all: if we have to improve India’s health, where should we start?

And for all of these reasons (and so many more) it makes sense for all of us to be aware of the results of the NFHS survey.


What is the NFHS Survey?

The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. The NFHS is a collaborative project of the International Institute for Population Sciences(IIPS), Mumbai, India; ICF, Calverton, Maryland, USA and the East-West Center, Honolulu, Hawaii, USA. The Ministry of Health and Family Welfare (MOHFW), Government of India, designated IIPS as the nodal agency, responsible for providing coordination and technical guidance for the NFHS. NFHS was funded by the United States Agency for International Development (USAID) with supplementary support from United Nations Children’s Fund (UNICEF). IIPS collaborated with a number of Field Organizations (FO) for survey implementation. Each FO was responsible for conducting survey activities in one or more states covered by the NFHS. Technical assistance for the NFHS was provided by ICF and the East-West Center.

http://rchiips.org/nfhs/about.shtml

Why is the NFHS important?

Why do we have something like NFHS? To obtain data on health and nutrition, disaggregated to the level of districts. We want to take stock of developmental targets at a single point in time and wish to track improvements (or deterioration) over time.

https://www.newindianexpress.com/opinions/columns/2021/dec/13/nfhs-andwhy-surveys-are-better-than-asking-a-cab-driver-2394809.html

How often is the NFHS carried out?

That’s a little tricky to answer, but I can tell you that there have been five rounds so far. The first one was in 1992-93, the second in 1998-99, the third in 2005-06, the fourth in 2015-16 (and this decade long gap is why this question is a little tricky to answer) and the fifth in 2020-21.

OK, so we can use this data to see how health in India has evolved over time?

Um, not exactly:

To gauge improvements over time, ideally, we should have what statisticians and economists call a panel. In a panel, across time, questions are asked to the same individuals/households. For something like NFHS, that’s not possible. In addition, for NFHS-5, compared to NFHS-4 (2015–16), additional questions have been asked. For those questions, gauging improvements over time is naturally impossible.

https://www.newindianexpress.com/opinions/columns/2021/dec/13/nfhs-andwhy-surveys-are-better-than-asking-a-cab-driver-2394809.html

Then what can we use the data for?

Especially because the answer to the first question in this series included this: “wish to track improvements (or deterioration) over time.”

Well, yes, it did. And we do use this data to see how health in India has evolved over time. But it’s not a perfect comparison, because we aren’t tracking the same households over time, and it therefore isn’t an apples to apples comparison. But the perfect shouldn’t be the enemy of the good, especially in public policy! The fifth round has in fact been structured in such a way so as to make the results as comparable as possible.

How many households are covered?

NFHS-5 fieldwork for India was conducted in two phases, phase one from 17 June 2019 to 30 January 2020 and phase two from 2 January 2020 to 30 April 2021 by 17 Field Agencies and gathered information from 636,699 households, 724,115 women, and 101,839 men

http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf

What questions are asked in this survey?

That’s a great question to ask!

Four Survey Schedules – Household, Woman’s, Man’s, and Biomarker – were canvassed in local languages
using Computer Assisted Personal Interviewing (CAPI).

In the Household Schedule, information was collected on all usual members of the household and visitors who stayed in the household the previous night, as well as socio-economic characteristics of the household:

water, sanitation, and hygiene; health insurance coverage; disabilities; land ownership; number of deaths in the household in the three years preceding the survey; and the ownership and use of mosquito nets.

The Woman’s Schedule covered a wide variety of topics, including the woman’s characteristics, marriage, fertility, contraception, children’s immunizations and healthcare, nutrition, reproductive health, sexual behaviour, HIV/AIDS, women’s empowerment, and domestic violence.

The Man’s Schedule covered the man’s characteristics, marriage, his number of children, contraception, fertility preferences, nutrition, sexual behaviour, health issues, attitudes towards gender roles, and HIV/AIDS.

The Biomarker Schedule covered measurements of height, weight, and haemoglobin levels for children; measurements of height, weight, waist and hip circumference, and haemoglobin levels for women age 15-49 years and men age 15-54 years; and blood pressure and random blood glucose levels for women and men age 15 years and over. In addition, women and men were requested to provide a few additional drops of blood from a finger prick for laboratory testing for HbA1c, malaria parasites, and Vitamin D3.

http://rchiips.org/nfhs/NFHS-5_FCTS/India.pdf

Whoa, that’s… a lot!

Indeed it is! If you haven’t clicked through to those PDF’s that have been linked to in the previous question, take the time out to go and do so. Conducting one of these surveys isn’t easy. All of these, and across these numbers (636,699 households, 724,115 women, and 101,839 men) is pretty tough, and kudos to the team that did the work.

So how are these households selected?

Another excellent question. From the interview manual (and if you are a student of statistics, this manual ought to be mandatory reading):

All 29 states and seven union territories (UTs) will be included in NFHS-5. NFHS-5 will provide
estimates of most indicators at the district level for all 707 districts in the country as on 1 March
2017.

For NFHS-5, the sample consists of approximately 30,456 clusters (small geographically defined
areas) throughout the country. The households in each of these clusters have recently been listed or
enumerated. A sample of households was then scientifically selected to be included in NFHS-5 from
the list in each of the clusters. Each of these households will be visited and information obtained
about the household using the Household Questionnaire. Women and men within these households
will be interviewed using an Individual Questionnaire. Women age 15-49 years will be interviewed
using the individual Woman’s Questionnaire. Men age 15-54 years will be interviewed using the
individual Man’s Questionnaire. We expect to complete interviews with about 7,45,488 women and
1,19,501 men in 670,032 households in this survey.

http://rchiips.org/NFHS/NFHS5/manuals/NFHS-5%20Interviewer%20Manual_Eng.pdf

And how are the surveys conducted?

During NFHS-5 fieldwork, you will work in a team consisting of one field supervisor, three female
interviewers, and one male interviewer. Each team will be provided with a vehicle and driver for
travelling from one Primary Sampling Unit (PSU) to another to conduct the fieldwork.
In addition, the team will include two health investigators. These individuals will be responsible for
drawing blood from eligible persons for testing for anaemia status, blood pressure, and blood glucose. In
addition, the health investigators will collect blood drops from a finger stick on filter paper cards,
which will be tested for malaria, HbA1c, and Vitamin D3 in ICMR laboratories. They will also be
responsible for the anthropometric measurements of eligible women, men, and children. The supervisors
will also receive some biomarker training so that they can supervise the health investigators and assist
them as needed. All interviewers will be trained to assist the health investigators in taking the
anthropometric measurements(height, weight, and waist and hip circumference measurements).
Each team supervisor will be responsible for his/her team of interviewers and health investigators.
The specific duties of the supervisor are described in detail in the Supervisor’s Manual.

http://rchiips.org/NFHS/NFHS5/manuals/NFHS-5%20Interviewer%20Manual_Eng.pdf

This PDF, the one that I have excerpted from, is 182 pages long. I am not for a moment suggesting that all of you must read every single word. But I’ll say this much: if you are currently studying either statistics or economics, you should go through it more than once. It is one thing to learn from textbooks, and quite another to understand the on the ground realities.


In tomorrow’s post, let’s dig in and take a look at the data itself, and see what the NFHS-5 results tell us about our country’s health.

Make Examinations Relevant Again

Alice Evans (and if you are unfamiliar with her work, here’s a great way to begin learning more about it) recently tweeted about a topic that is close to my heart:

And one of the replies was fascinating:


I’ve asked students to create podcasts in the past for assignments, but not yet for final or semester end examinations, because I am constrained by the rules of whichever university I’m teaching in. There are some that allow for experimentation and off-the-beaten-path formats, but the vast majority are still in “Answer the following” mode.

But ever since I came across that tweet, I’ve been thinking about how we could make examinations in this country better, more relevant, and design them in such a way that we test skills that are applicable to the world we live in today, rather than the world of a 100 years ago.

To me, the ideal examination would include the following:

  • The ability to do fast-paced research on a collaborative basis
  • The ability to work as a team to be able to come up with output on the basis of this research
  • The ability to write (cogently and concisely) about how you as an individual think about the work that your team came up with

What might such an examination look like? Well, it could take many forms, but here’s one particular form that I have been thinking about.

Imagine an examination for a subject like, say, macroeconomics. Here’s a question I would love to ask students to think about for such an examination today. “Do you and your team find yourself on Team Transitory or Team Persistent when it comes to inflation today? The answer, in whatever format, should make sense to a person almost entirely unacquainted with economics.”

This would be a three hour long examination. Say the exam is for a cohort of 120 students. I’d split the class up into 10 groups of 12 each, and ask each group to spend one hour thinking about this question, and doing the research necessary to come up with an answer. They can discuss the question, split the work up (refer to textbooks, refer to material online, watch YouTube videos, discuss with each other, appoint a leader – whatever it is that they need to do) and come up with an outline of what their answer is.

The next hour would be coming up with the answer itself: write a blogpost about it, or record audio, or record video. The format is up to them, as is the length. The only requirement is that the output must answer the question, and must include reasons for their choice. Whether the background information that is required to make sense is to be given (or referenced, or skipped altogether) is entirely up to the students.

And the final hour must be spent on a short write-up where each individual student submits their view about their team’s submission. Given that the second hour’s output was collaborative, does the student as an individual agree with the work done? Why? Or why not? What would the student have liked to have done differently? This part must be written, for the ability to write well is (to me) non-negotiable.

To me, this examination will encompass research (which can only be done in an hour if the students are familiar enough with the subject at hand, so they need to have done their homework), collaboration and the ability to think critically about the work that they were a part of. Grading could be split equally on a fifty-fifty basis: half for the work done collaboratively, and half for the individual essay submission.


Sure, there would be some problems. Students might object to the groups that have been formed or students might end up quarreling so much in the first two hours that they’re not left with much time. Or something else altogether, which is impossible to foresee right now.

But I would argue that such examinations are more reflective of the work that the students will actually do in the world outside. More reflective than “Answer the following” type questions, that is.

The point isn’t to defend this particular format. The point is to ask if the current format needs to change (yes!) and if so how (this being only one suggestion).

Right now, examinations provide a 19th century solution to very real 21st century problems, and their irrelevance becomes ever more glaring by the day.


We need to talk about examinations, and we aren’t.